Application
for Employment
City of Lamar, Mo. Parks & Recreation Dept. Today’s date ______
All
applicants are considered for all positions regardless of race, color, creed,
national origin, ethnic origin, age, religion marital or veteran status,
presence of non-job-related medical condition, handicap or other legally
protected status. You must be at least 16 years of age by the first day of
employment to be offered a position.
|
Name
|
Home
Phone |
Soc.
Sec # |
|
Address
|
Cell
phone (if have) |
Valid
DL #
Have
____yes
____
no
Chauffeur? |
|
City/
State / Zip |
Or
- Message phone |
E-mail
Address (if have) |
Position
Applying for
_________________________________________________________
Education
attained: __
High School or G.E.D.
__
Some College
__
College Degree
__
Trade
__
Other
References :
Complete all information for
these people NOT related to you
|
Name |
Address |
Phone |
How
Long |
Relationship |
|
Name |
Address |
Phone |
How
Long |
Relationship |
|
Name |
Address |
Phone |
How
Long |
Relationshi |
Employment
History Beginning
with the most recent, list all former employers. Make note of times of
schooling, employment and/or
unemployment for past ten years. If you need more space, write on the back.
|
From To (Dates) |
Employer Name, |
Phone |
|
|
Your Job |
Address, |
Supervised by: |
|
|
What did you do |
Why did you leave |
||
|
From To (Dates) |
Employer Name, |
Phone |
|
|
Your Job |
Address, |
Supervised by: |
|
|
What did you do |
Why did you leave |
||
|
From To (Dates) |
Employer Name, |
Phone |
|
|
Your Job |
Address, |
Supervised by: |
|
|
What did you do |
Why did you leave |
||
Have
you ever been employed by the City of Lamar before?
__
No
___
Yes- If yes, when _________________
I
certify the statements of my application are true to the best of my ability and
knowledge. I understand that any false statement on this application will
constitute grounds for my not being considered for this or any position, or if
hired, for immediate dismissal.
I ________________________________________hereby authorize the release of any information the City of Lamar deems necessary in it's background investigation for employment. This information shall include but not be limited to past employment and traffic or criminal records. I also release the City of Lamar, its employees and agents, and any other organization or business that releases information from any liability that may arise from the gathering of such information.
Print Name _______________________________ Date ____________ Signed: _______________________________